11 There are 11 human OATPs, subdivided into 6 families ( Table 1). Organic anion transporting polypeptides (OATPs) are membrane transport proteins that facilitate the sodium-dependent influx of endogenous and exogenous substances across biological membranes. 10 The present article examines how fruit juice intake may influence the bioavailability of orally administered medications.įruit Juice and Organic Anion Transporting Polypeptides In this regard, grapefruit juice-drug interactions involving cytochrome P450 (CYP)3A4 are well known, 9 and pomegranate juice-drug interactions were recently examined in this column. 8 Additionally, many fruit juices contain substances that can cause drug interactions. 7Ĭonsumption of fruit juice is also associated with health concerns for example, a meta-analysis of cohort studies showed that the regular intake of sugar-sweetened (but not 100% natural) fruit juice increased the risk of diabetes mellitus. 6 Anti-inflammatory, antioxidant, cytoprotective, antigenotoxic, and antitumoral constituents have been identified in orange juice. For example, orange juice reduces low-density lipoprotein cholesterol levels 5 and may have favorable effects on bone health. 4 Orange juice is similarly associated with health benefits. 3Īpples are traditionally associated with large health benefits, as implied by the proverb “An apple a day keeps the doctor away.” In vitro, in vivo, and even clinical data on the antioxidant, antiproliferative, and cell signaling effects of apple juice suggest the possibility of benefits related to cognitive decline of normal aging, diabetes, weight management, bone health, pulmonary function, and gastrointestinal function. 1, 2 This may explain why fruit juice intake is associated with clinically relevant gains in observational studies for example, the regular intake of fruit and vegetable juice may delay the onset of Alzheimer’s disease. Could drinking apple or orange juice regularly, or taking medications with these beverages instead of with water, result in clinically significant food-drug interactions in patients receiving psychotropic medications?įruit juices contain vitamins, antioxidants, electrolytes, trace elements, and other nutrients that are associated with potential health benefits for example, constituents with anti-inflammatory, antioxidant, antiobesity, antidiabetic, and antitumoral properties have been identified in pomegranate juice. © Copyright 2014 Physicians Postgraduate Press, Inc.Īpple juice and orange juice are popular beverages. Doing so is especially desirable with grapefruit juice, orange juice, and apple juice with commercial fruit juices in which OATP-inhibiting substances are likely to be present in higher concentrations with calcium-fortified fruit juices and with medications such as atenolol and fexofenadine, the absorption of which is substantially diminished by concurrent fruit juice intake. Patients should therefore err on the side of caution, taking their medications at least 4 hours distant from fruit juice intake. While there is no evidence, so far, that OATP inhibition affects the absorption of psychotropic medications, there is no room for complacency because the field is still nascent and because the necessary studies have not been conducted. These fruit juices diminish the gastrointestinal absorption of certain antiallergen, antibiotic, antihypertensive, and β-blocker drugs. Fruit juices such as grapefruit juice, orange juice, and apple juice contain substances that are OATP inhibitors. In enterocytes, OATPs facilitate the gastrointestinal absorption of certain orally administered drugs. OATPs are found in enterocytes and hepatocytes and in brain, kidney, and other tissues. Organic anion transporting polypeptides (OATPs) are a group of membrane transport proteins that facilitate the influx of endogenous and exogenous substances across biological membranes.
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